Reader request: Pool exercises for the Sacroiliac Joint and Low Back

Update, Jan. 2018:  Hi everyone– I’ve learned a ton since I wrote this post.  Please be sure to check out my new site, My Sacroiliac Joint Saga, for more! 

Hi everyone!

I’ve been getting a ton of requests recently for the exercises I do for the SI joint.  Here’s a basic run-down of some of the things that have helped me!

The Exercises:

Standing on a “noodle” on one leg and trying to balance– works the core and improves balance.

(I’m assuming most people know what a pool noodle is, but here’s an example just in case).

When I first started trying to balance on a noodle it was pretty hard just to stand upright.  As I got stronger over time, it became easier and easier, so I had to add variations to make it more difficult.

As it gets easier, you can experiment with waving your arms around, kicking your other leg around, or leaning back and forth. You want to be at the point where you’re almost falling off the noodle but not quite. It’s your core muscles that will engage every time you “regain” your balance.

Note: I always felt this more in my core when I was first starting out, but my physical therapist promised it was also using the muscles of my whole back.

“Lying Down Superman” — Works your whole back

I do this exercise while floating on my back (so I can breathe). Instead of lifting arms and legs up off the mat, you are pushing them down into the water. I position a noodle underneath me, running across my lower back, so that it’s easier to float.

I am still somewhat out of shape, so for me, simply using the resistance of the water is enough. My arms and legs want to float, so pushing them down into the water requires some force.

If this is too easy for you, you can put some sort of floation device under your hands, feet, or both, to add more resistance as you push them down into the water.

Strength Training versus Cardio

Strength training is based around doing a small number of repetitions (most people say between 8 and 15) where you’ve pretty much exhausted those specific muscles at the end.  This is how you build short term strength in a muscle, for carrying heavy things, lifting things, or exerting a lot of force at one time.

Cardio/endurance, on the other hand, means you’re performing an activity for 20-30 minutes and you do feel tired at the end, but it’s more of a “whole-body” type of tired, and you could keep going if you had to.

Both strength and endurance are really important to develop to keep your whole body functioning optimally, although to stabilize the hip joint, strength is technically the first thing you should be concentrating on.

The muscles of the hip

The muscles of the hip run all around the front and back of the pelvis, and are important for helping to stabilize the SI joints.

I have a feeling that the best thing for the person who asked for these exercises will be to do them while floating, so that she is not bearing weight through her sacroiliac joints.

The only videos I could find were of people doing these exercises on land. I am just including them for a visual aide… but preferably, in the pool, you would use some kind of floatation device or noodle(s) to float and then let your legs hang down.

So here are examples of the main motions you want to practice doing until the point of (relaxed, painless) exhaustion.

Hip Flexion: aka bringing leg straight forward in front of you

Here are some detailed instructions from BodyBuilding.com.  (I’m definitely not a body builder and I know you probably aren’t either, but their site is still really useful!).

You can see the person in this video is using a band for resistance. I haven’t quite figured out how to use bands in the pool (what would I attach them to?). But you can experiment with finding other ways to create resistance if it’s too easy for you otherwise, like maybe adding ankle weights or ankle floats (like the ones shown below).

You can use these for the following hip muscle exercises as well:

Hip Extension: aka pushing leg straight in back of you. Only go as far as is comfortable for you—don’t push through any pain.

Hip Abduction:

Hip Adduction: The opposite of hip abduction.  Instead of raising your leg out to the side, you’re bringing it down closer to the center of your body.

Again, all of these hip motions you can perform in the water.  You can do them standing in the shallow end, or while letting your legs hang beneath you in the deep end.

The most important stretch I do: One Knee to Chest Stretch

After I had been doing this stretch every day for a week, I started to notice a big improvement in how the area around my sacroiliac joints felt.

Here are some instructions from BodyBuilding.com.

Hold for 15-30 seconds, repeat at least once.  I only do one leg at once– doing both legs at the same time really aggravated my SI joints.

This post is really just a starting point.

The point of this post was to give you a sense of what you might want to be doing, and to help you start to envision a pool routine.   If you’ve having SI joint problems, the best thing you can do is to consult an aquatic physical therapist who’s also familiar with the SI joint (hopefully you can find one!).  Then, she can help you find a way to work these muscle groups that works for you.

It’s not so important how you do these motions—in the pool vs. out of the pool, floating vs. standing in the shallow end, so much as you can find a way to practice them—to the point of exhaustion—without experiencing a big increase in pain.  We are all different (particularly in our SI joints) so it is totally fine for you to find a way that works for you.

For more:

I have so many more posts about exercises for the SI joint over on my new blog, My Sacroiliac Joint Saga.

• I have general information about exercise and important muscle groups in my Strengthening section
• As well as a more specific section on Aquatic Exercise, which is the number one form of exercise I recommend for the SI joint.

Hope that was helpful!  If you have any questions, feel free to drop them in the comments below!